Loading...
HomeMy WebLinkAboutMiscellaneous - 290 BARKER STREET 10/28/2015 � g9i 6P�m North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 290 Barker St. MAP: 061.0 LOT:0029 INSTALLER:John DiVincenzo DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS D-Box INSPECTION: i, DATE OF BED BOTTOM INSPECTION: '.. DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑ Contractor reports any changes to design plan ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK ❑ Building sewer in continuous grade,on compacted firm base ❑ Cleanouts per plan ❑ Bottom of tank hole has 6"stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading ❑ Monolithic tank construction ❑ Water tightness of tank has been achieved by - visual testing ❑ Inlet tee installed,centered under access port ❑ Outlet tee installed,centered under access port (gas baffle/effluent filter) ❑ inch cover to within 6"of finish grade installed over one access port ❑ Hydraulic cement around inlet&outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6"stone base ❑ Weep hole plugged ❑ 1500 gallon Pump Chamber installed ❑ H-10 loading ❑ Monolithic tank construction ❑ Inlet tee installed,centered under access port ❑ Pump(s)installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ cover at final grade installed over pump access port ❑ Water tightness of tank has been achieved by testing ❑ Hydraulic cement around inlet&outlet Comments: CONTROL PANEL ❑ Alarm&Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel:basement ❑ Alarm signal located inside:basement Comments: DISTRIBUTION-BOX ., Installed on stable stone base H-20 D-Box ❑/ Inlet tee(if pumped or>0.08'/foot) ©/ Hydraulic cement around inlet&outlets Observed even distribution Speed levelers provided(not required) Schedule 40 PVC Pipe Comments. Commonwealth of Massachusetts osi 000zsL°i BOARD OF HEALTH P—N° • North Andover BHP-2015-0881 P.I. FFF ',.. F.I. $125.00 DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted John DrVincenzo to(Repair)an Individual Sewage Disposal System. at No 290 BARKER STREET as h on the ppl ton for D p 1 W rks C tr ction P ermit No BHP-22015 088 _Dated October 09,2015 - Iss d On Oct-09 2015 OP IIEALTII Commonwealth of Massachusetts M,, 131-kL°t r 06t.o0029 BOARD North CER IPI TE MPLI NC HIS TOCERT FThatth Individua Sewage isposal Sys an(Repair) by Jo_ Divine, zo -No 290 RKE�IorksConstmctior,Perbditb[o.SIRE S' has been installed ance with the provisions fTI'f[,E 5 of the State Euviro c tal Code as described in the ac '.i applicationfor Dispo BHP-2015-088 Dated October 09,2015 Pr t d On:Oct-09-2015 BOARD Of HEALTA P1'a„',,, Commonwealth of Massachusetts MV-Bi°ck-Lt 057.00029 BOARD OF HEALTH Yon,i vo North Andover BHP-2015-0881 '...... FCC $125.00 . -"-------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted John DiVineenzo to(Repair)an Individual Sewage Disposal System. at No 290 BARKER STREET as shown on the application for Disposal Works Construction Permit No. BIIP-2015-088. Dated October 09,2015 Issued On Oct-09-2015 -BOARD Of HEALTH ;�1� Application for Septic Disposal System TODAY'S DATE Construction Permit—TOWN OF NORTH ANDOVER MA 01845 $125.00—Component $125.00-Component Important: Applicationis hereby ma de forapermitto: '.. When filling out Construct a new on-site sewage disposal system" '.. forms on the omputer,use I]Repair or replace an existing on-site sewage disposal system` // to m ove our G tab key 5l air or replace an existing system component—What?��/sib'- cursor do not oaemererrn A Facility Infer ferm ti key. ✓ C _m 7, ✓ i`I 00 t# _.... {�q rJx tT CilylTOwn 2.-*TYPE OF SEPiTIC SYSTEM*: Y ❑Pump Gravity(choose one) ""If pump system,attach copy of electrical permit to application'"" '.. ❑Conventional System(pipe and stone system) Y ❑Infiltrator or Biodiffuser(Gravel-Less)(Attach a copy of your certification to install this type ofsystem) ➢ ❑Pressure Distribution S.A.S.(No D-Box) D O Pressure Dosed(D-Box Present)S.A.S. �- Y ❑Does the system require an effluent filter? Yes_ No If yes,does plan specify make and model of fitter? YES=(no further info,needed) NO=(installer must specify brand of filter before DWC issuance) Ilrbntie M,khket lPbarie an,Modell 2. Own r Information T"�rcKu�a�t J Na 7 Address(f tliflerent(roma e) city Slate zip Code Email address Telephone Number 3. Installer Information . r Name of COmpanY..... City ITOV✓n Slate Telephonc Phone#P f lease) a. Designer Information Name Name of Company Address Cily)T— State Zip Code Telephone Number(Best#fo Reach) Application for Disposal System Conslructlon Permit•Page 1 of 2 a Application for Septic Disposal System Construction Permit—TOWN OF �oAVSOAIP NORTH ANDOVER,MA 01845 $125.00-Component PAGE 2 OF 2 A.Facility Information continued.... S. Type of Building:❑Residential Dwelling or❑Commercial B.Agreement The undersigned agrees to ensure the construction and maintenance of the afore-described on-site ewage disposal system in accordance with the provisions of Title 5 of the Envir an' Co a as well as the Local Subsurface Disposal Regulations for the Town of North A dov r.1 ers nd that until a/final Certificate of Compliance has been issued by this o rd Hea ,th installed system is not approved. •` l l t // Na oaia AN p m e i pprov By_,���d .(th of, Representative) `� � oaie I/- Application Disapproved for the following reasons: For Office Use Only: 1 FecAitach d? Y I// No 2. Pr ject Manager Ohligation F,�—Attuched.Yo YesV No 3. PumPS s>—?Ifs-,Attach copy cfElectrical Perrnit Yes_ No AppBcantreceived c py of "Electrical Inspection Notes for Septic Systems" Yes N Handout? 4. Reviewed approvalletter all paperwork received? Yes_ No M'ssing; S. Foundation As-Built?(hew construction only); Yes_ N (Same scale as approved plan) . 6. Floor P/ams?(new construction only): Yes N Application far Disposal System Construction Permit•Page 2 of 2 SEPTIC SYSTEM INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover hcensed installer for the construction for the septic system for the property at: (ddb pup So msrzm) Focplanaby Rela'yc to the applic inn of�J6F,J 1 �1✓1 b✓,n/['mod�+'1.� (lneallu:n.mc) And dated Dared ze? unto , With re_ ns dated (Iarr,evi+ui date) I understand the following obligations for management of this project: 1. As the installer,I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site.1 must have the approved plans and the permit on,site when any work is '.. being done '.. 2. As the installer,I must call for any and all inspections. If homeowner,eontsaetr,project manager,or any other person not associated with my company schedules an inspection and the system is not ready,then . item three shall be applicable 3. As the installer,I am required to have the necessary work completed prior to the applicable inspections as indicated below.I understand that requesting an inspection,without completion of the items in accordance with Title 5 and the Board of Health Revelations may result in a$50.00 Fine being levied against me and/or my company. a. Bottom of Bed-Generally,this is the first(1')inspection unless there is a ret inmg wall,which should be done first.The installer most request the inspection but does not have to be present. b. Final Construction Inspection-Engineer must first do their inspection for elevations,ties,etc. As-bolt of verbal OK(or r-mail t Lifl7,f�-I t(t n;ylj_ tl 1 -in)from the engineer must LLt. be submitted to the Board of Health,after which installer calls for an inspection time Installer must be present for this inspection.With a pump system,all electrical work must be ready and able to cause pump to work and alarm to function. c. Final Grade-Installer muse request inspection when all grading is complete.Installer does not have to be on-site. 4. As the installer,I understand that only I may perform the work(other thav strap/e excauaaoi)and I am required to complete the installation of the system identified in the attached application for installation,I further understand that work done by others unlicensed to install sep tics stems in North Andover can constitute reasons for denial of the system and/or revocation or suspension of my Ilcense to operate in the I—of North Andover significant fines to all e ns involved are also possible. 5. As the installer,I understand that I must be on-site during the perfounance of the f llowing construction steps: a. Determination that the proper elevation of the excavation has been reached. b. Inspection of the sand and stone to be used. c. Final inspection by Board of Healtb staff or consultant. d. Installation of tank,D-Box,pipes,stone,vent,pump chamber,retaining mall and other components. G. As the installer.I undcrsta d that I am solely responsible for the installation of the system as per the a >n-oved plans.No instructions bv the homeowner.er-;P end contractor or any other e rso ns shall absolve me of this obligation. ondcrsigned Lierasrd Srptielastaller: i (radar. �n liJ P1u21